Date of Award


Document Type


Degree Name

Doctor of Psychology (PsyD)


Graduate Department of Clinical Psychology

First Advisor

Nancy Thurston, PsyD

Second Advisor

Mark McMinn, PhD

Third Advisor

Marilyn Charles, PhD


Dissociation commonly occurs as a defense against trauma and can be understood as a breakdown in metacognition. The present research investigated the relationship between trauma, dissociation, and metacognition in subjects with PTSD, a trauma-related disorder. Specifically, we investigated a potential inverse relationship between metacognition and dissociation in participants who have undergone psychoanalytic therapy. Participants were patients admitted to the Austen Riggs Center, who consented to be a part of the Follow Along Study (FAS), a longitudinal investigation spanning 15 years. Quantitative and qualitative analyses examined differences in themes of dissociation across initial and follow-up-clinical interviews. Quantitatively, all subscales for metacognition showed significant and large improvements after psychoanalytic therapy. Qualitatively, follow-up-interviews revealed greater remembering, selfacceptance, emotional accessibility, generosity, and social connectedness. Thus, psychoanalytic therapy increased participants’ metacognitive abilities, allowed participants to develop a more coherent narrative of the self, and reduced participants’ dissociative tendencies. Implications and future directions are discussed.